President message

Dear EFN Members and Colleagues,

2016 is now coming to an end with a lot of challenges still in front of us in terms of health and wellbeing. So, we can say that 2017 is going to be, again, another very challenging year in which we will need, more as before, speak with one voice for nurses!

From an EFN lobby perspective, Directive 55 and its accurate transposition & implementation at EU Member States level has always been key, and will stay like that. Knowing that many Member States (14) did not yet transposed the Directive into their national legislation, they risk facing infringements procedures beginning 2017. This is really a shame, as the art 31 of DIR55 is key to develop nursing!

Next to that, the EFN will continue advocating making concrete progress in the nursing workforce composition, in which national political decisions often downgrade the health sector, to make it all cheaper. It is therefore important developing an EU Blueprint for the evolvement of the Nursing Profession, taking on board todays’ achievements and challenges, and innovations, to support the frontline workforce in their daily clinical practice.

More than before, patient safety & quality of care becomes an important political topic with research on the Value-Based Healthcare Ecosystem informing EU and national policies to get better outcomes, on health and wellbeing.

Therefore, it is very important that nursing research take up a more prominent role when designing EU policies, with the European Nursing Research Foundation (ENRF) taking the lead in the design of evidence based policies, fitting frontline. As such, nurses close the gap between theory and practice!

I would like to take this opportunity to wish all the EFN Members, EFN key partners and EU key policy players collaborating closely with the nurses, and EFN in particular, a happy new year. May 2017 bring you all the best, as well as the right policies and tools to achieve a better health and wellbeing for all, building on the hard work delivered by millions of nurses in the EU, Europe and globally. Looking forward to continue this close collaboration and alliances with you in 2017.

Finally, it is with great sadness that the EFN was informed that Dame Sheila Quinn, a woman who played a crucial role in developing nursing education at EU level, and even establishing EFN, passed away on 8 December at the age of 96. On behalf of all EFN members, it is rightly to say that this is a huge loss for all of us who knew her and especially for the nursing community, in the UK but also internationally! We will remember her as the great and very active woman she was, who contributed so much to advance the nursing profession both at national and international levels.

I wish you all happy holidays and a successful 2017!

Marianne Sipilä
EFN President

News from EFN

Czech Republic Nursing EducationIt is with great pleasure that the EFN was informed by its Member from Czech Republic, the Czech Nurses’ Association, that after long and difficult negotiations with the Health Ministry, their nursing education will not be downgraded. The reason for refusing the new law was the fact that the Czech nursing organizations, supported by EFN, addressed the education and workforce political discussion by relating outcomes to quality and safety. Howver, the nurses argument is that national government needs to comply with EU Directives. This was the case with this crucial topic – Nursing Education, ruled by the EU Directive 2005/36/EC, modernised by Directive 2013/55/EU. In an open letter the EFN made it clear to the Czech government that the nursing education has to follow the EU requirements, and that it is not possible to imagine a situation when lowering the level of education would be compatible with the EU law. The positive outcome in this debate is that the new Czech Health Minister agrees with the EFN position that shortening nursing education would bring the nursing profession back in time. What we need to keep in mind, and the EFN hopes that this will serve as an example to other EU countries discussing downgrading education for the nursing profession, mainly former Communist countries, is that it is crucial to ensure appropriate education and qualifications, and allow opportunities to advance the nursing profession to guarantee the sustainability of the health workforce, and to safeguard the willingness of young people to keep on choosing nursing as a career path. It is crucial that national governments make sure that health systems have the necessary and motivated nursing workforce, with the necessary competences, to provide patient-safe and high-quality healthcare services. Congratulation to the Czech Nurses!

European Health WorkforceCreating a sustainable health workforce implies strong human resource strategies integrated into workforce planning, with strategies that include greater incorporation and planning skills needs, skill mix and moving towards advanced roles. Therefore, it is crucial that at local, national, and EU levels, policy-makers and competent authorities make sure that the health facilities have the necessary nursing workforce, highly qualified and motivated, to provide safe and high quality healthcare services. The Expert group on

European Health Workforce made it clear that a good outcome depends on the engagement of the stakeholders’ in the dialogue with the EU key policy & decision makers, and that it is key to listen and engage frontline. During the expert meeting, the EFN made it clear that nurses are eager to bring their expertise into the political debate. Now, it is up to the European Commission and the EU Member States to listen to them, to be open, and to create an effective workforce policy leading to concrete outcomes.

Open InnovationNurses are engaged in innovation. At healthcare level, these are key components as ‘Innovation’ as a response to major societal challenges is not only about technologies designed by researchers in labs, it requires the involvement of the users, frontline, from the start of the design. Better connection and communication between science and society is urgently needed. But how will this work out in Horizon 2020? Therefore, the EFN expressed that the review of Horizon 2020 will need to focus on frontline first! Engaging nurses in largescale proposals, in a systematic and coordinated way, will need to replace tradition work packages. Open innovation needs to follow frontline, and frontline will then follow open innovation. This is key to impact positively on the health ecosystem, instead of pushing for disruptive business models, which do not provide solutions for frontline, instead they create more challenges. Furthermore, aligning technology with ethical values will help advance innovation, especially in nursing. It is important to incorporate ethical aspects of human well-being that may not automatically be considered in the current design and manufacture of artificial intelligence and autonomous systems. Nurses realise that robotics technology will significantly change our life and offers many opportunities in work environments. Science communication and science for policy-making is therefore key, 3 million nurses frontline communicating with citizens, engaging with how the world might work in the future. Quoting Prof. Jerzy Buzek, former EP President and Polish: “Europe’s weakness today is that we are not responding to the expectations of our citizens. We have to give back hope to Europeans and certainly innovation is the answer we could give to our citizens to many of their questions.”

News from the EU

Research and Innovation performance and Horizon 2020 country participationThe European Semester, the Commission’s yearly cycle of economic policy coordination, supports Member States’ structural reforms in different policy areas to promote jobs, growth and investment. That is why the Commission gives recommendations to and closely work with the Member States to increase the performance of their national research and innovation systems. To view key, research-related data, and recent success stories on projects relating to your country, click here.

Furthermore, the European Commission published a brochure entitled “Research and Innovation Funding: Making a Real Difference”, that shows an assessment of Horizon 2020 management and distribution throughout 2014-2015, with information including number of proposals and accepted applications, time-to-grant, and key Horizon 2020 performance indicators.

Study on the International sectoral qualifications Frameworks and SystemsCarried out on behalf of the European Commission, this study reflects on the potential role of the European Qualifications Framework (EQF) in supporting recognition of International Sectoral Qualifications and related initiatives, and shows that in the field of qualifications these are a reality that cannot be neglected as in some cases they concern high numbers of people. Most are also described in learning outcomes and pay attention to issues of renewal of qualifications/initiatives and their quality assurance. The study also provides clear recommendations on how to take this further.

European Commission launches Solidarity CorpsThe European Commission launched, on 7 December 2016, the European Solidarity Corps, aiming to allow young people (between the ages of 18 and 30) to sign up for volunteering or a traineeship, apprenticeship or job, lasting from 2 to 12 months. This initiative is aiming to provide valuable skills and experience at the start of their careers. Participants will be able to sign up for activities addressing issues such as: education; health; social integration; assistance in the provision of food; shelter construction; reception, support and integration of migrants and refugees; environmental protection; and prevention of natural disasters (excluding immediate response). The objective is to get 100,000 young people signed up to the Corps by 2020. Participating in its launch event on 7 December, in Brussels, the EFN sees this as a very good opportunity for our young nurses. With the current challenges that the EU is facing as unemployment among the young people, having the right professional, with the right skills, at the right place, doing the right things, is crucial.

EU Study on Big Data in Public Health, Telemedicine and HealthcareA Study identifying examples of the use of Big Data in Health has been published, providing recommendations on 10 key topics: awareness raising; education and training; data sources; open data and data sharing; applications and purposes; data analysis; governance of data access and use; standards; funding and financial resources; and legal and privacy aspects. Those recommendations are aiming at maximising opportunities Big Data can bring to public health in the EU to benefit European citizens and patients in terms of strengthening their health and improving the performance of Member State’s health systems. They are also being seen as suggestions for the European Union and its Member States on how to utilise the strengths and exploit the opportunities of Big Data for Public Health without threatening privacy or safety of citizens and will feed into the Commission’s actions to develop a Big Data value chain in the context of the European Digital Market Strategy.

In this context of big data, the EFN participated in a conference in London, on 16 December, which brought together leaders in the field, from academia, industry and policy, to discuss what data should be collected and measured, looking at some case-studies, and the problems of measuring it, as:

measuring the right things, with the correct systems? Will healthcare workers co-operate, and administrators properly analyse the data? And will policy makers act on it? This debate will take place in several EU Member States, and we ecourage nursing leaders to engage in this discussion, making sure nursing data, qualitative data are picked up to measure outcomes.

Antimicrobial ResistanceOn the occasion of the 9th European Antibiotic Awareness Day (EAAD), taking place every year on 18 November, and which the EFN follows very closely, the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, reminded that EU Stakeholders and Member States actions at EU level have had a clear added value, as recognised by independent evaluators, and have provided a framework to guide and coordinate activities on Antimicrobial Resistance at European and international level. But more work is needed. To take further the fight against Antimicrobial Resistance the Commission will launch, in 2017, a second Action Plan building upon and strengthening the work done, next to supporting the EU Member States in the implementation and monitoring of their National Action Plans. EFN regrets key NGOs have been isolated in a purely voluntary participation. Is this what governments mean by stakeholder engagement?

The EFN highly regrets that all upcoming Joint Actions, on several important topics linked to nursing, nurses are not engaged substantially, as partner. And if they want, NGOs can take leave from their job and sponser themselves to join all these meetings throughout the EU. This new attitude in the Commission, pushed by the Member States, will have a negative impact on outcomes and trust. A real shame!

Malta EU PresidencyOn 1st January 2017, Malta will take over the Presidency of the Council of the European Union from Slovakia. Together with its trio partners (The Netherlands and Slovakia), Malta participated in setting out the Council’s programme identifying the main areas of its work over the 18-month period between January 2016 and June 2017. On the basis of this programme, each trio member then prepares a 6-month detailed programme highlighting a set of key issues to be given priority during this period. For Malta, the key priorities will be on migration, security, social inclusion, Europe’s neighborhood, and Single Market, and namely the Digital Single Market, a topic of key importance for the nurses. In terms of health, Malta presidency will focus on cross-border cooperation, and accessibility and affordability of medicines. When it comes to CHILD OBESITY, nurses coaching role, in particular public health nurses, school nurses, are ideally positioned to work at all levels (individually, with the family, etc.) and to make change happen through eHealth services in nursing and social care. The public health prevention is key to change lifestyle of young people, by using modern technology as “serious gaming” and “avatars”. Public health nurses aim is to harness the potential of eHealth solutions to make effective guidance available in accessible formats. Through E-Coaching nurses coach children in developing lifelong habits, and advocate/accompany them for a change in their lifestyles. The coaching role in public health is needed in order to have a significant impact on the lifestyle of children and usually by the entire family. On the topic, SUSTAINABLE MODELS OF STRUCTURED COOPERATION BETWEEN HEALTH (and SOCIAL) CARE SYSTEMS, health policies are still geared towards hospitalization and institutionalisation. It is within this political and policy context that EFN offers its position on ‘bringing care back to the Community’ to stimulate change. Nurses as care coordinator have proven to be effective in contributing to better outcomes. These advanced roles are crucial in making progress to reform the health systems, and to facilitate the shift in health care towards a more integrated model with the focus on prevention and continuity of care. Successfulness and sustainability need to be ensured while efficiency must increase, by focussing on advanced roles, strengthen public health interventions and innovative technologies.

Publications

EU Accession Policy Window OpportunityThe European enlargement has been studied in a wide range of policy areas within and beyond health. Yet the impact of EU enlargement upon one of the largest health professions, nursing, has been largely neglected. This publication explores the nurse leadership using a comparative case study method, aiming to analyse the extent to which engagement in the EU accession policy-making process provided a policy window for the nurse leaders to formulate and implement a professional agenda while negotiating EU accession.

Health at a Glance: Europe 2016
The joint European Commission & OECD “Health at a Glance: Europe 2016” report, has been published. Providing updated analysis of the health status of EU citizens and the performance of health systems, it shows that policies that aim at promoting good health and preventing diseases as well as more effective healthcare could save lives and billions of euros in the European Union. This is the first of other publications, with a next one in November 2017, providing the country health profiles of all 28 EU countries highlighting the particular characteristics and challenges of each of them.